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General NPI Number Information
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NPI Number | 1346105939
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Entity Type | Individual
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Provider Name | ASHLEY LYNN POLCOVICH
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Gender | Female
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 901 COURT ST
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City | SUNBURY
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State | PA
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Zip | 17801-2853
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Country | US
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Telephone | 570-286-7121
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Fax | 570-286-9463
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Provider Business Mailing Address
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Address Line | 701 MARKET ST
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City | ASHLAND
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State | PA
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Zip | 17921-1250
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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